The Question that Dare Not Be Asked

In the New York Times science section today (August 31), Weill Cornell Medical College psychiatrist Richard Friedman writes about how illicit drugs like cocaine and methamphetamine may permanently reduce a person's capacity for enjoying life's splendors. These drugs, he notes, activate the brain's reward system by releasing dopamine. However, he observes, the brain then tries to compensate for the drug's presence, and it does so by becoming less sensitive to dopamine. The brain may end up with a "less responsive reward circuit," Friedman writes, which never fully repairs itself even after the drug use stops. The result is that the person may then be condemned to "endure a dulled life."

All of that may be true. But here is what is missing from this article. Ritalin and the other stimulants used to treat ADHD in children also activate the dopamine system. Ritalin, in fact, does it in much the same manner that cocaine does, and with equal potency. (The difference is that Ritalin is not cleared from the body as quickly as cocaine, and thus a dose of Ritalin has longer-acting effects than cocaine.) In response, the stimulant-using brain undergoes changes that make it less sensitive to dopamine release -- it is trying to compensate for the drug's presence.

And so now the obvious question. If this process, in those who use cocaine or other illicit drugs, may lead to a "less responsive reward circuit," which never fully repairs itself even after the drug use stops, isn't there a similar risk with putting children on Ritalin or other stimulants? Is this treatment that may cause children to "endure a dulled life" as adults?

It seems like a question that psychiatry -- based on this article by Richard Friedman in the New York Times -- should ask.

Thanks Robert for the heads-up on Friedman's article and for asking the question. My brother is a bit of an excitement junkie who was coerced by Mum as a young kid to take Ritalin. She in turn was heavily pressured from many school staff to get him on it--circa mid-80s.

My brother is a fairly low-key, nerdy guy that you wouldn't think of as an intense action type. But if he doesn't get his fix of high-risk sports, he can fall into a minor gloom where life just doesn't seem 'intense' enough.

It's always and reliably treated by going out and getting another action-adrenaline fix. He empowered me to write a little bit of his perspective about his alleged ADD symptoms and experiences.

It has long been my contention that there are two ways to get drugs in the United States: from the corner street-dealer downtown or from your friendly physician. The cost, both in dollars and side-effects, is about the same. You pose the question: “…isn’t there a similar risk with putting children on Ritalin or other stimulants?” Well, where you see risk, a pharmaceutical company sees opportunity. And an adult whose reward circuit has been permanently compromised as a result of childhood ingestion of Ritalin is exactly what the pharmaceutical companies and the psychiatrists want: a client for life. Follow the money.

My son was enrolled in a major university study at the age of 9 months. He was seen by a team of neurologists at one of the most famous medical centers in the world. He was extremely advanced in his motor skills and this caused problems. Eventually we were referred to psychiatric and he "went down the rabbit hole" something I deeply regret my part in. After his entire childhood was spent on every drug imaginable, he dropped out of school and became very antisocial, but no psychiatrist wanted to see him THEN. No, he wasn't their problem. He was OURS. He turned to every street drug imaginable and is still a heavy marijuana user now aged 25. His life is nothing to him. He cannot drive, cannot hold down a job, has been through multiple "interventions" all pointless. How can a child who was called "patient" for all of his life, ever have any of the "self esteem" the schools preach they need? His takeaway was that he was worthless. Only lovable when medicated. Only valuable as a person to be picked apart, with no privacy even in his very MIND. I wish with all my heart that some person would have stepped forward and screamed, DON"T TRUST THESE DOCTORS! He has attempted suicide so many times I have lost count, but we don't seek "medical help" because that way lies MADNESS. Please, mothers, fathers, do not do this to your child. Ritalin is a gateway drug and all the others that follow cause iatrogenic disease. ALL OF THEM without exception are dangerous. I would rather have my overactive little boy back, in all his innocence than have the zombie I have now.